What is considered atrophy in a brain structure per MRI volumetrics (NeuroQuant and Neuroreader)?
Re: What is considered atrophy in a brain structure per MRI volumetrics (NeuroQuant and Neuroreader)?
Brain (The), I’m not in NC (although I wish I was). The facility I found was in Covington (north of New Orleans). I will attempt to make sure that I’m going to end up with some paper that indicates the particular brain area and the volume % (compared to expected volume for my age?) before I get the MRI. I need to find out their deliverables and if necessary find someone as you suggest. Is there any value in talking with NeuroQuant beforehand? I guess from your previous comments that the results pkg from the MRI companies typically do not give you the simplified story. Thanks for help.
Re: What is considered atrophy in a brain structure per MRI volumetrics (NeuroQuant and Neuroreader)?
Kurt,
I think it’s a great idea to determine beforehand what reports you will/can get from the imaging center. I got three NeuroQuant reports; a friend got five NeuroQuant reports. I would have rather gotten five. The more information the better, as far as I’m concerned. And yes, whether you go with NeuroQuant or Neuroreader, one of the reports should show the volumes of 39+ structures with how your volumes compare to healthy men your age. I also think it’s a great idea for you to talk to NeuroQuant (CorTechs Labs) beforehand. You could ask them about the possibility of running NeuroQuant against your previous MRI images. You could also ask them about how an imaging center determines which reports to run and whether you can make a request of which reports are run. I know my doctor just ordered the MRI with NeuroQuant, not specific reports.
Please let us know what you find out.
I think it’s a great idea to determine beforehand what reports you will/can get from the imaging center. I got three NeuroQuant reports; a friend got five NeuroQuant reports. I would have rather gotten five. The more information the better, as far as I’m concerned. And yes, whether you go with NeuroQuant or Neuroreader, one of the reports should show the volumes of 39+ structures with how your volumes compare to healthy men your age. I also think it’s a great idea for you to talk to NeuroQuant (CorTechs Labs) beforehand. You could ask them about the possibility of running NeuroQuant against your previous MRI images. You could also ask them about how an imaging center determines which reports to run and whether you can make a request of which reports are run. I know my doctor just ordered the MRI with NeuroQuant, not specific reports.
Please let us know what you find out.
ApoE 4/4 - When I was in 7th grade, my fellow students in history class called me "The Brain" because I had such a memory for detail. I excelled at memorization and aced tests. This childhood memory helps me cope!
Re: What is considered atrophy in a brain structure per MRI volumetrics (NeuroQuant and Neuroreader)?
TheBrain,
A set-back on getting a brain MRI with volume calculations. My neurologist's nurse called me today and let me know that he would not write an order for an MRI unless it was done by the Neuromedical facility - where there is no brain volume MRI capability to my knowledge (I had previous MRI's there before when I started having speech/spelling problems and no one had heard of volume calcs). So, I need to scramble and see if I can find another neurologist or give in. I was hoping the volume information might indicate how far I'm gone and possibly give some info as to what kind of dementia I have (neuropsychologists don't think I have ALZ, yet my mother's side was decimated by ALZ).
A set-back on getting a brain MRI with volume calculations. My neurologist's nurse called me today and let me know that he would not write an order for an MRI unless it was done by the Neuromedical facility - where there is no brain volume MRI capability to my knowledge (I had previous MRI's there before when I started having speech/spelling problems and no one had heard of volume calcs). So, I need to scramble and see if I can find another neurologist or give in. I was hoping the volume information might indicate how far I'm gone and possibly give some info as to what kind of dementia I have (neuropsychologists don't think I have ALZ, yet my mother's side was decimated by ALZ).
Re: What is considered atrophy in a brain structure per MRI volumetrics (NeuroQuant and Neuroreader)?
Hi Kurt, sorry for your struggles! This may be where asking NQ themselves about using MRI images could be helpful. As long as they do the right kind of MRI and will give you a CD, I think maybe it can be run through their software by a neurologist anywhere who does that. I'm not sure, as TheBrain says, maybe not. Keep probing and keeping us posted.Kurt wrote:TheBrain,
A set-back on getting a brain MRI with volume calculations. My neurologist's nurse called me today and let me know that he would not write an order for an MRI unless it was done by the Neuromedical facility - where there is no brain volume MRI capability to my knowledge (I had previous MRI's there before when I started having speech/spelling problems and no one had heard of volume calcs). So, I need to scramble and see if I can find another neurologist or give in. I was hoping the volume information might indicate how far I'm gone and possibly give some info as to what kind of dementia I have (neuropsychologists don't think I have ALZ, yet my mother's side was decimated by ALZ).
ApoE 3/4 > Thanks in advance for any responses made to my posts.
Re: What is considered atrophy in a brain structure per MRI volumetrics (NeuroQuant and Neuroreader)?
Kurt, I'm sorry to hear your neurologist is unwilling to accommodate your request. I truly believe that the insights gained from MRI volumetrics are invaluable, and every neurologist and radiologist should embrace this technology.
I agree with circular that now could be the time to contact CorTechs Labs and ask your questions. However, if you choose to "give in," as you put it, I understand. It can be exhausting fighting these battles.
The first radiologist who interpreted my MRI images did not interpret my NeuroQuant reports because doing so was "beyond the scope of his practice". He was kind enough to talk to me on the phone for 10–15 minutes and answer my questions, which I'm grateful for. I asked him if the atrophy he sees is beyond what's expected for my age (even my doctor couldn't tell based on the radiologist's written report). The radiologist said, yes, the atrophy is beyond what's expected for my age. I then asked him if he could tell where the atrophy was occurring. He said the atrophy was in my frontal lobes.
Wrong! My frontal lobes are mostly fine. I do have some atrophy, especially in the Lateral Orbito Frontal. But it's my white matter and temporal lobes that are the problem areas. Without volumetrics, I'd never know the truth. Without volumetrics, radiologists and neurologists are at risk of simply guessing and getting it wrong. I think it's important to know what's really going on in there.
I agree with circular that now could be the time to contact CorTechs Labs and ask your questions. However, if you choose to "give in," as you put it, I understand. It can be exhausting fighting these battles.
The first radiologist who interpreted my MRI images did not interpret my NeuroQuant reports because doing so was "beyond the scope of his practice". He was kind enough to talk to me on the phone for 10–15 minutes and answer my questions, which I'm grateful for. I asked him if the atrophy he sees is beyond what's expected for my age (even my doctor couldn't tell based on the radiologist's written report). The radiologist said, yes, the atrophy is beyond what's expected for my age. I then asked him if he could tell where the atrophy was occurring. He said the atrophy was in my frontal lobes.
Wrong! My frontal lobes are mostly fine. I do have some atrophy, especially in the Lateral Orbito Frontal. But it's my white matter and temporal lobes that are the problem areas. Without volumetrics, I'd never know the truth. Without volumetrics, radiologists and neurologists are at risk of simply guessing and getting it wrong. I think it's important to know what's really going on in there.
ApoE 4/4 - When I was in 7th grade, my fellow students in history class called me "The Brain" because I had such a memory for detail. I excelled at memorization and aced tests. This childhood memory helps me cope!
Re: What is considered atrophy in a brain structure per MRI volumetrics (NeuroQuant and Neuroreader)?
Circular/THEBrain
Thanks for the comments. I did find some parameters on the NeuroQuant website that looked like info on which older MRI's might be read in the software. I'll need to get the details on the older machines. Haven't gotten around to talking to Cortechlabs/NeuroQuant yet. My scheduled MRI (via my neurologist) is next Thursday, so I need to decide shortly whether to go ahead (and get a NeuroQuant MRI test after that with probably no insurance help) or just back out of the current MRI test and see if I can find another Neurologist (they are in short supply here - long waits). Just thinking now, maybe I could get him to delay next Thursday MRI to give me more time.
Thanks for the comments. I did find some parameters on the NeuroQuant website that looked like info on which older MRI's might be read in the software. I'll need to get the details on the older machines. Haven't gotten around to talking to Cortechlabs/NeuroQuant yet. My scheduled MRI (via my neurologist) is next Thursday, so I need to decide shortly whether to go ahead (and get a NeuroQuant MRI test after that with probably no insurance help) or just back out of the current MRI test and see if I can find another Neurologist (they are in short supply here - long waits). Just thinking now, maybe I could get him to delay next Thursday MRI to give me more time.
Re: What is considered atrophy in a brain structure per MRI volumetrics (NeuroQuant and Neuroreader)?
Hi Kurt,Kurt wrote:My scheduled MRI (via my neurologist) is next Thursday, so I need to decide shortly whether to go ahead (and get a NeuroQuant MRI test after that with probably no insurance help) or just back out of the current MRI test and see if I can find another Neurologist (they are in short supply here - long waits). Just thinking now, maybe I could get him to delay next Thursday MRI to give me more time.
As someone who will be getting another MRI tomorrow to mark the first year of the 5-8 year Generations I trial, my advice would be that you don't want to stack your MRIs that close together, and that the 30 minutes of noise (even with headphones and music) is something that you also don't want to do more than necessary! I have been told by the Generations staff that my MRI "looks good" and know that they would tell me if it showed microbleeds or white matter disease. But beyond that, I don't want the numbers that The Brain is brave enough to ask for. Mostly because it's like knowing I have osteopenia. Ok, I am at risk for progression to osteoporosis, but so far at age 66 I haven't lost any appreciable height, I don't have any functional limitations, I am following recommendations for Vitamin D etc. What will it help if I know that my hippocampus has shrunk by 10%, or 50%? I don't know if that's happened over the last year, or happened 10 years ago and has been stable since. I don't know if new neurons are compensating for that.
As someone who did diagnostic tests of kids with learning differences for decades, I could tease a lot of information out of a score. But without talking to the teachers, observing the child and meeting with the parent, I was still unable to say even "what it means for now" and very little about "what it means for his/her future".
People of all ages often do amazing things with brains that would appear on imaging studies to not be up to what they are in fact doing every day!
4/4 and still an optimist!
Re: What is considered atrophy in a brain structure per MRI volumetrics (NeuroQuant and Neuroreader)?
I came across this 2017 study correlating MoCA results in presymptomatic individuals with volumetrics:
Release
Study shows dementia-related brain changes are identifiable even before problems are noticeable
Paper behind a paywall
Human anterolateral entorhinal cortex volumes are associated with cognitive decline in aging prior to clinical diagnosis
Sadly, although my hippocampal volume is good, my entorhinal cortex regions are in just the 13th and 12th %iles for the left and right respectively. While the 'anterolateral entorhinal cortex' specifically doesn't show on my report, I can't see how it would be doing very well given the overall entorhinal cortex score. Maybe I'll ask my doc to do a MoCA
In response to NF52's concern with possibly learning of brain region volume issues without having anything to do about it, I've long been interested in how meditation affects the brain. There are studies that indicate meditation increases sizes of brain areas related to memory, and decreases the size of the amygdala, which is associated with stress, fear and anxiety (no surprise my amygdala is rather gargantuan!). Similarly, exercise is said to increase brain volumes. I'm glad I have a baseline so I can look for improvements down the road, but one doesn't need a baseline to benefit from emerging interventions.
Release
Study shows dementia-related brain changes are identifiable even before problems are noticeable
Paper behind a paywall
Human anterolateral entorhinal cortex volumes are associated with cognitive decline in aging prior to clinical diagnosis
A larger study is planned or underway.Abstract
We investigated whether older adults without subjective memory complaints, but who present with cognitive decline in the laboratory, demonstrate atrophy in medial temporal lobe (MTL) subregions associated with Alzheimer's disease. Forty community-dwelling older adults were categorized based on Montreal Cognitive Assessment (MoCA) performance. Total gray/white matter, cerebrospinal fluid, and white matter hyperintensity load were quantified from whole-brain T1-weighted and fluid-attenuated inversion recovery magnetic resonance imaging scans, whereas hippocampal subfields and MTL cortical subregion volumes (CA1, dentate gyrus/CA2/3, subiculum, anterolateral and posteromedial entorhinal, perirhinal, and parahippocampal cortices) were quantified using high-resolution T2-weighted scans. Cognitive status was evaluated using standard neuropsychological assessments. No significant differences were found in the whole-brain measures. However, MTL [medial temporal lobe] volumetry revealed that anterolateral entorhinal cortex (alERC) volume—the same region in which Alzheimer's pathology originates—was strongly associated with MoCA performance. This is the first study to demonstrate that alERC volume is related to cognitive decline in undiagnosed community-dwelling older adults.
Sadly, although my hippocampal volume is good, my entorhinal cortex regions are in just the 13th and 12th %iles for the left and right respectively. While the 'anterolateral entorhinal cortex' specifically doesn't show on my report, I can't see how it would be doing very well given the overall entorhinal cortex score. Maybe I'll ask my doc to do a MoCA
In response to NF52's concern with possibly learning of brain region volume issues without having anything to do about it, I've long been interested in how meditation affects the brain. There are studies that indicate meditation increases sizes of brain areas related to memory, and decreases the size of the amygdala, which is associated with stress, fear and anxiety (no surprise my amygdala is rather gargantuan!). Similarly, exercise is said to increase brain volumes. I'm glad I have a baseline so I can look for improvements down the road, but one doesn't need a baseline to benefit from emerging interventions.
ApoE 3/4 > Thanks in advance for any responses made to my posts.
Re: What is considered atrophy in a brain structure per MRI volumetrics (NeuroQuant and Neuroreader)?
I'm new to this forum and new to trying to figure out why I have brain atrophy. I've been in treatment for CIRS and Lyme. We think we have that under control, at the moment. But I have the genetics that I will have to watch where I am with molds and biotoxins for life.
My initial Neuro Quant was thought the issues were due to CIRS and Lyme. But now that the brain swelling is down, the places thought compressed due to the brain swelling should have gotten better. But they havent, in fact they are worse. We figured out I still have MARCONS. My docs are now thinking that MARCONS can cause issue with brain atrophy. They are seeing this in children too (is what I was told). We are doing yet another treatment to get rid of the MARCONS. Hope this works!
I also have POTS and MCAS along with EDS. Some of the medicines I've had to be on could also cause cognitive problems. We are trying to get me off some of those and keep things as level as we can. I have found certain enzymes to be a great benefit. Also a glandular that blocks histamine is allowing me to nearly be off my Mast Cell medicines.
Issie
My initial Neuro Quant was thought the issues were due to CIRS and Lyme. But now that the brain swelling is down, the places thought compressed due to the brain swelling should have gotten better. But they havent, in fact they are worse. We figured out I still have MARCONS. My docs are now thinking that MARCONS can cause issue with brain atrophy. They are seeing this in children too (is what I was told). We are doing yet another treatment to get rid of the MARCONS. Hope this works!
I also have POTS and MCAS along with EDS. Some of the medicines I've had to be on could also cause cognitive problems. We are trying to get me off some of those and keep things as level as we can. I have found certain enzymes to be a great benefit. Also a glandular that blocks histamine is allowing me to nearly be off my Mast Cell medicines.
Issie
Re: What is considered atrophy in a brain structure per MRI volumetrics (NeuroQuant and Neuroreader)?
Dear Issie; you have your plate overflowing!Issie wrote:I'm new to this forum and new to trying to figure out why I have brain atrophy. I've been in treatment for CIRS and Lyme. We think we have that under control, at the moment. But I have the genetics that I will have to watch where I am with molds and biotoxins for life.
Issie
You will find other members with mast cell and EDS issues, and can find posts on these topics using our search function (magnifying glass right upper tool bar). I've seen some EDS folks use the term "connective tissue disease" or disorder. Sometimes it takes some effort to narrow search results down, but it is also helpful to communicate with others on the same path.
Slacker
E4/E4
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